Neck inspiratory muscle activation patterns during well-controlled inspiration

Surprisingly, the activation characteristics of the neck inspiratory muscles as a function of key inspiratory mechanical parameters have yet to be demonstrated experimentally under well-controlled conditions. This study aimed to elucidate the muscle activation patterns of the neck inspiratory muscles by strictly controlling flow rate and lung volume.

Thirteen healthy subjects matched their inspiratory flow rate at approximately 20-100% of peak flow rate (PFR) as steady as possible during inspiration. Amplitude of surface electromyogram (EMG) of the sternocleidomastoid (SCM) and scalene were calculated for every increase in %PFR over a duration corresponding to an increase in lung volume by 10% of forced vital capacity (FVC), as well as for every 5% increment of FVC over a point corresponding to an increase in flow rate by 20%PFR to determine the %PFR-EMG and %FVC-EMG relations, respectively.

Regression analyses showed that EMGs of the neck inspiratory muscles exponentially increased with increase in %PFR and their associated variables which reflect recruitment onset when increasing flow rate increased with increasing %FVC. In %FVC-EMG relation, a linear regression analysis showed positive slope at all %PFR and positive y-intercept at 80% PFR.

The main new finding is that the neck inspiratory muscle activities increase with flow rate as well as lung volume. The positive y-intercept of the %FVC-EMG relation at higher %PFR indicates that the neck inspiratory muscles are always activated even when lung volume level is low, implying that SCM is not necessarily an "accessory" muscle as described in previous observations.